This morning I had the pleasure of interviewing Simon Flack, a GP at Bournemouth Medical service and an advocate of Choosing Wisely. I spoke to Simon about Choosing Wisely and whether the initiative can get doctors to stop using the interventions with no benefit.
Do you think the Choosing Wisely initiative will work in the UK?
“I hope it does, I think if we put as much interest into the initiative as we do into selling medical stories in papers about wonder treatments and so on then I think it could be a really good initiative for rationalising the way they use treatment and getting people to think about their treatment but it is only a tiny part trying to counterbalance huge amount of information going into about their condition and their expectation around the way they are treated.”
Do you think the 5 questions patients have been told to ask their doctors will help to make a difference to the end treatment?
“Yes, I think that if patients are taught to have that kind of inquiry when they go to the doctor even though it could make consultations longer. I think the patients will come in naturally more sceptical about what is on offer and make sure what they get is what is right for them and they understand and they consent and explained to the pros and cons of what they might be doing.”
Are you going to implement choosing wisely here, and why?
“I think the initiative will be difficult for it to be driven from my side of the table because I’d like to think that I give my patients the chance to ask the right questions anyways but I think we need a general and a more informed consumers so that. It needs to be somewhere out there as a cultural change instead of something they learn about for the first time in when they visit a doctors surgery. Certainly if there are promotional materials around the surgery that we could use in waiting rooms then I would certainly adopt those.”
How can waste be reduced in the medical sector?
“One of the key statistic is that they reckon probably only about 50% of all medication that is prescribed is correctly complied with so with lots of medication people start it but give up on it very very soon. So a lot of it would be making sure they are comfortable and understand the reason why they are taking the medication in the first place and they have an informed discussion with their provider about whether they need it or not. If they come to a decision that they don’t need it, that can be discuss and made at the time where the medication is prescribed not when they already have boxes and boxes of the medication at home.”
How do you we can stop over treatment and over prescribing?
“We need to have very informed patients and a clinical evidence based which is balanced in the way which it balanced in the way it looks about the benefits of stopping treatment as well as starting treatment. The majority of clinical based evidence is around starting treatment, there is very few papers about what happens when you stop treatments. For instance in the last year, there has been thousands of paper about benefits of starting treatments in all that time I know of one paper that says about safely stopping treatment so there is a huge disparity.”
To read another article that Dr. Simon has been involved in click HERE